Abstract
Background
Attention-deficit/hyperactivity disorder (ADHD) is a major sequela of traumatic brain
injury (TBI) in youths. The objective of this study was to examine whether ADHD symptoms
are differentially associated with genetic risk and brain structure in youths with
and without a history of TBI.
Methods
Medical history, ADHD symptoms, genetic data, and neuroimaging data were obtained
from a community sample of youths. ADHD symptom severity was compared between those
with and without TBI (TBI n = 418, no TBI n = 3193). The relationship of TBI history, genetic vulnerability, brain structure,
and ADHD symptoms was examined by assessing 1) ADHD polygenic score (discovery sample
ADHD n = 19,099, control sample n = 34,194), 2) basal ganglia volumes, and 3) fractional anisotropy in the corpus callosum
and corona radiata.
Results
Youths with TBI reported greater ADHD symptom severity compared with those without
TBI. Polygenic score was positively associated with ADHD symptoms in youths without
TBI but not in youths with TBI. The negative association between the caudate volume
and ADHD symptoms was not moderated by a history of TBI. However, the relationship
between ADHD symptoms and structure of the genu of the corpus callosum was negative
in youths with TBI and positive in youths without TBI.
Conclusions
The identification of distinct ADHD etiology in youths with TBI provides neurobiological
insight into the clinical heterogeneity in the disorder. Results indicate that genetic
predisposition to ADHD does not increase the risk for ADHD symptoms associated with
TBI. ADHD symptoms associated with TBI may be a result of a mechanical insult rather
than neurodevelopmental factors.
Keywords
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Article Info
Publication History
Published online: July 12, 2018
Accepted:
June 28,
2018
Received in revised form:
June 12,
2018
Received:
February 12,
2018
Identification
Copyright
© 2018 Society of Biological Psychiatry.
